Metal-on-Metal Hip Resurfacing and Total Hip Arthroplasty in the Same Patient: A Case Series Comparison

Early outcomes for metal-on-metal total hip resurfacing (MOMHR) suggest that it may have a role as a bone-sparing alternative to total hip arthroplasty (THA) in younger patients. The possible biomechanical advantages of MOMHR over THA have been extensively discussed in the published data and have been clinically examined. However, few studies have offered a direct, controlled comparison of patients' experiences after MOMHR and THA. To more accurately describe differences in patient outcomes between MOMHR and THA in comparable patients, we present a report of 8 patients who had both MOMHR and a contralateral THA. This report included a patient-completed hip comparison questionnaire that assessed hip pain, stiffness, surgical recovery, proprioception, hip strength, and overall preference. Most patients preferred MOMHR, citing reasons such as better range of motion, improved proprioception, and a faster, easier recovery. These preferences may likely be related to the biomechanical advantages of a larger femoral head. However, it is important to consider how differences in the time elapsed since the patients' index surgeries, changes in surgical technique and differences in rehabilitation affect patients' preferences. At this point, there are on-going prospective clinical trials comparing MOMHR to THA, and only after long-term reports are critically examined there may be more definitive recommendations.